Gujarat's 27% healthcare facilities 'mixing up' biomedical and municipal waste: Study

By Jag Jivan  
Finding “serious gaps” in disposing of biomedical waste in Gujarat, a new study, jointly carried out by Delhi-based environmental group Toxics Link in collaboration of Ahmedabad’s Paryavaran Mitra, has found that 13% of health facilities in what India’s powers-that-be consider “model state” have not even tied up with a Common Bio Medical Waste Treatment Facility (CBWTF), a condition without which they are not allowed to operate under law.
Worse, in a “grave” violation, the study said, 27% of the surveyed facilities are mixing their biomedical waste with municipal waste, while 15% facilities are disposing of their hazardous waste along with biomedical waste (BMW). This not only violates the law but also leads to increased infectious waste volumes as well as release of toxic products into the environment.
According to the study, titled ‘Don’t Dump That’, which seeks to assess the current status of hospital waste management in four major districts of Gujarat – Ahmedabad, Rajkot, Gandhinagar and Sabarkantha – most healthcare facilities including clinics pay no attention to occupational health and safety of the healthcare staff.

Thus, it said, activities like needle recapping were prevalent in 87% of the facilities and around 90% lacked any policy for post exposure prophylaxis. Pointing out that absence of needle cutters from important points in hospitals is a serious concern and may result in needle stick injuries and also needle reuse, it added, needle injuries have been globally identified as one of the key reasons for the spread of infectious diseases like Hepatitis and HIV among health care staff.
Satish Sinha, associate director, Toxics Link, cautioned, “The biomedical waste management rules in Gujarat are not being implemented on ground by most healthcare facilities specially the small clinics. Regulatory agencies need to strengthen the system and take legal action against healthcare facilities not following proper norms and also closely monitor the CBWTFs.”
The study, which collected data on biomedical waste management practices pre-Covid from 145 healthcare facilities from these four districts, including government and private hospitals and small clinics, found that the segregation practices were not proper in many of the facilities.
Most of the facilities visited had not installed an effluent treatment plant and many of them were not even connected to tertiary effluent treatment plants and were releasing liquid waste directly into the sewage system, it added.
The study further said, many hospitals were also not pre-treating their laboratory waste which is required as per the rules. Since most of the healthcare facilities are operating without adhering to the norms of the biomedical waste 2016 rules, it raises a question on the quality of monitoring mechanisms being adopted in the state.

The study found the condition of the waste storage areas in most hospitals poor and violating the norms laid by the 2016 rules, adding, the concerns related to functioning of CBWTFs, as there have been several reports earlier of the violations by some of them. “We found bags filled with waste lying unattended in some of the hospital premises”, said Paryavaran Mitra’s Mahesh Pandya.

Some key findings

• Most healthcare facilities (HCFs) do not have their own websites, which is mandatory under the new rules
• Most HCFs have not uploaded their annual report on their website, mandatory under the new Rules.
• Biomedical waste generation records highlight improper reporting and mixing of general waste with biomedical waste.
• Poor infrastructure in the storage areas, basic requirements not met.
• 13% facilities visited under the study not connected to CBWTFs
• 27% facilities disposing municipal solid waste along with biomedical waste
• 15% facilities disposing hazardous waste along with biomedical waste
• Filled waste bags lying unattended in the hospital premises
• 19% facilities not pre-treating their microbiological waste/lab waste
• Most facilities lack pre-treatment equipment like microwave/ autoclave
• None of the hospitals have installed effluent treatment plant
• Recapping of needle, a frequent activity seen in 87% HCFs and in 100% clinics
• Lack of policy for post exposure prophylaxis
• Information and communication material not placed at strategic locations
• Case study and existing reports show appalling conditions of CBWTFs.